吸入一氧化氮对室间隔缺损合并肺动脉高压的疗效观察

Effect of inhaled nitric oxide on postoperative patients with ventricular septal defect and severe pulmonary hypertension

目的观察吸入一氧化氮(NO)对室间隔缺损术后重度肺动脉高压的疗效。方法选择2004年2月至2005年1月收治的室间隔缺损并重度肺动脉高压患者16例为治疗组,在呼吸机辅助期间吸入外源性NO;以2003年2月至2004年1月收治的室间隔缺损并重度肺动脉高压(PH)13例为对照组,回顾性分析比较两组患者血液动力学参数、动脉血氧分压及相关时间参数,并进行统计学分析。结果吸入NO可以显著降低心率,对中心静脉压也有明显的降低作用。虽然两组经皮血氧饱和度无明显差别,但是吸入NO组PaO2显著提高。治疗组呼吸机辅助时间、ICU监护时间、住院时间均明显短于对照组。两组平均动脉压差别无统计学意义。吸入NO后二氧化氮、高铁血红蛋白含量明显高于吸入前(P<0.05),但仍在允许范围。结论吸入NO是治疗VSD手术后PH的一种有效的方法。

Objective To evaluate the effect of inhaled nitric oxide （NO） on postoperative patients with ventricular septal defect （VSD） and severe pulmonary hypertension （PH）. Methods Sixteen postoperative patients with VSD and severe PH from February 2004 to January 2005 inhaled NO during the mechanical ventilation. Thirteen patients with the same diseases from February 2003 to January 2004 without NO inhalation were considered as the control group. The hemodynamic variables and other relative parameters of the 2 groups were analyzed retrospectively. Results After NO inhalation, heart rate and CVP decreased significantly. Though SPO2 in 2 groups was nearly at the same level, the PaO2 level in NO inhalation group elevated significantly. The durations of mechanical ventilation, staying in ICU and hospitalization of the NO inhalation group reduced obviously. The mean systemic artery pressure showed no change. During NO inhalation, blood nitrogen dioxide and methemoglobin were found at normal levels. Conclusion NO inhalation is an effective method to the postoperative patients of VSD with severe PH.